Inspection on 13/06/06 for The Old Vicarage

This inspection was carried out on 13th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Old Vicarage 10/07/07

The Old Vicarage 30/01/06

The Old Vicarage 01/12/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Old Vicarage Weekly Village Kettering Northants NN16 9UP Lead Inspector Mrs Kathy Jones Unannounced Inspection 13th June 2006 08:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Vicarage Address Weekly Village Kettering Northants NN16 9UP Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01536 484378 01536 485168 admin@theoldvic.co.uk Royal Bay Care Homes Helen Angela Elmore Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. No one falling within the category of OP may be admitted into the home for nursing care where there are 38 persons in the category of OP already accommodated within the home with nursing needs. No one falling within the category of OP may be admitted into the home for personal care where there are 38 service users accommodated in the home No person under the age of 65 years of age may be admitted to the home. No service user requiring nursing care may be accommodated in the rooms 2a, 7 and 10 on the first floor 30th January 2006 Date of last inspection Brief Description of the Service: The Old Vicarage is a care home providing personal care and accommodation and in some cases nursing care for 38 older people over the age of 65 years. The home is owned by Royal Bay Care Homes. The Old Vicarage care home is situated in the village of Weekley, close to the town of Kettering in Northamptonshire. The building is a listed building that has been adapted to meet the needs of the nursing and residential clients living there. The home has both single and shared bedroom accommodation with all rooms having en-suite facilities. There is a variety of communal rooms for residents’ use, and a well tended, pleasant garden and patio area for use when the weather permits. The following fees were provided by the registered manager as being current at the time of submission of the pre-inspection questionnaire on 8 June 2006: • Residential £380:00 to £475 per week. • Nursing £500:00 to £650 per week. The fees include personal care and nursing care where admitted for nursing care, accommodation, meals, laundry and activities. Chiropody and hairdressing services can be arranged and are charged separately. Other costs would include newspapers, clothing, toiletries, and purchases from the shop. The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. All standards identified as ‘key’ standards and highlighted through the report were inspected. The key standards are those considered by the Commission to have a particular impact on outcomes for residents. Inspection of the standards was achieved through review of existing evidence, pre-inspection planning, an unannounced inspection visit to the home and drawing together all of the evidence gathered. The pre-inspection planning was carried out over the period of half a day and involved reviewing the report of statutory inspections carried out in June 2005 and January 2006 and the service history, which details all contact with the home including notifications of events reported by the home and telephone calls. A pre-inspection questionnaire submitted by the registered manager was received following the inspection and prior to the production of the report. Some of this information has been included in the report. The information gathered assisted with planning the particular areas to be inspected during the visit. The unannounced inspection visit covered the morning and early afternoon of a weekday. The inspection was carried out by ‘case tracking’ which involves selecting residents’ and tracking their care and experiences through review of their records, discussion with them, the care staff and observation of care practices. The inspector also met with other residents’ who were not part of the case tracking process and visiting relatives to listen to their views on the care provided. The management of residents’ medication was reviewed. Staff files were not available at the time of this unannounced inspection so the adequacy of staff training and recruitment procedures were assessed through discussion with staff including two recently recruited staff. Communal areas and a sample of residents’ bedrooms were viewed and observations were made of residents’ general well being, daily routines and interactions between staff and residents. Feedback on the inspection findings was given to the assistant care manager and nurse in charge throughout the inspection visit. Additional issues were clarified with the registered manager in a telephone call following the inspection and some feedback given. The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: While there were some good examples of detailed care plans to instruct and guide staff in meeting resident’ needs, others contained only minimal information and had not been kept up to date to reflect current care needs. A recommendation has been made regarding care plans and the registered manager was receptive to advice given. Some quality assurance systems are in place however it was identified that currently visits by a representative of the organisation are mainly announced and the registered manager does not receive a report of the findings. A The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 7 recommendation has been made to review this to ensure that standards are maintained and residents’ needs continue to be met. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, Std 6 is not applicable, as the home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. The admission process establishes the homes ability to meet the needs and preferences of people admitted to the home prior to admission. EVIDENCE: Review of two residents’ care files confirmed that an assessment of need is carried out prior to residents being admitted to the home and an assessment is obtained from the local authority where applicable. The assessments were found to be detailed and to take account of individual preferences and to check residents’ understanding of the reasons for admission to the home. Discussion with two residents’ about their admission to the home identified that they had been happy to rely on their families to find a suitable home. Their relatives had visited the home following a recommendation and had been supplied with information about the services the home provides. The residents’ were happy that the home met with their expectations. The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 10 The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. The overall care provided appears to be good however the lack of up to date care plans in some cases has the potential to put residents at risk of their needs not being fully met. EVIDENCE: Residents and relatives spoken to during the inspection were happy with the care being provided. Staff response to the call bell was discussed with one resident who said that staff always respond quite quickly and if busy say when they will be back. Observations, discussion with staff and residents’ confirmed that staff are aware of and able to meet residents’ needs. A sample check of three care files identified that care plans are in place to instruct and guide staff in the actions they need to take to meet residents’ needs. In some cases these were very detailed for example one care plan for personal care specified what the resident was able to manage independently and what staff needed to do to The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 12 assist reducing the risk of the resident losing independence unnecessarily. In other cases it was found that care plans were not up to date or did not contain full information to guide staff. Examples were discussed with staff during the inspection and included a movement and handling plan for one resident which had not been updated following an improvement in her condition and the lack of a plan for a resident who was confused and verbally aggressive. Discussion with residents’ and staff confirmed that health care services are accessed appropriately for residents’. A sample check of the medication system confirmed that there is a clear system in place for the management and recording of medication administered. The majority of medication is supplied in a blister pack format, which aids stock control and auditing. No discrepancies were identified during a sample check and residents’ prescribed medication was available and signed as administered in accordance with the prescription. Observations and discussions with residents’ during the inspection confirmed that staff speak to and treat residents’ with respect. Their privacy and dignity is respected in that personal care is provided in the privacy of people’s rooms. Residents’ preferences in relation to things like make up are respected and a staff member was assisting a resident in her room to re-apply lipstick. The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. Visitors are encouraged and welcomed into the home and residents’ are very happy with the quality of food provided. Routines are flexible and allow residents’ choices in their daily lives. EVIDENCE: An activity organiser is employed in the home and arranges various activities. A cream tea to be held in the garden has been organised for this month where there will also be a singer. A range of social activities are posted on the notice board however on the afternoon of the inspection it was a very warm afternoon and residents’ were reluctant to be involved in an organised activity so the time was spent with individual residents’. One resident enjoyed a walk around the gardens with the activity organiser to pick some flowers. Residents’ religious needs are checked during the assessment process and a staff member advised that arrangements are made for those residents’ who wish to receive communion in the home. The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 14 The inspector met with some residents’ in their bedrooms who said they were able to choose whether they spent time in their bedroom or in the communal lounges. One resident confirmed that staff would also assist them to the garden if they wished. Visitors spoken to during the inspection confirmed that they are always made welcome and that arrangements for visiting are flexible. All residents’ spoken to were very happy with the meals provided. Observations at breakfast time identified that the cook was aware of individual preferences, which included, some residents’ having a full cooked breakfast, another had bacon sandwiches and another prunes. Lunch was a choice of sausage and onion pie or pork and mushroom fricasse’. The food was freshly cooked, well presented and a sample of the pie confirmed it was very tasty. Meals for residents’ who require their food liquidised were attractively presented with each item liquidised separately improving the visual appearance and the taste. Records show that residents’ weight is monitored and nutritional assessments carried out to identify those who may be at risk. The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. The home has procedures for dealing with concerns and complaints which residents and relatives are aware of and staff are aware of their responsibilities for protecting the people in their care. EVIDENCE: The Commission for Social Care Inspection have received no complaints about the service since the last inspection. The registered manager has advised that the home has received no complaints since the last inspection. A copy of the complaints procedure is displayed in the hall. Residents’ spoken to said that they felt able to raise any concerns with staff and were confident that this would be dealt with. Discussion with a member of staff confirmed that a concern raised by a resident had been appropriately dealt with. Staff spoken to had no concerns about how residents’ were being treated and were aware of their responsibilities to act to protect residents’. The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, 26 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. The home was clean, comfortable and in good decorative order providing a pleasant environment for residents’. EVIDENCE: A limited tour of the premises was conducted; the residents bedrooms viewed were pleasantly decorated, furnished to a good standard and contained small personal possessions, such as photographs, pictures and ornaments. There are bedrooms on the ground and first floor, some single and some shared with all having en-suite toilet facilities. A lift provides access to the first floor. There are two lounges, two dining rooms and one lounge/dining area on the ground floor. These areas were clean, pleasant and comfortably furnished. The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 17 The home is set within gardens, which were attractive and well maintained at the time of the inspection. Residents’ confirmed that they are able to access the gardens as and when they wish and staff provide assistance where necessary. All areas of the home were clean and free from offensive odours. A resident told the inspector that the cleaner is always very through when cleaning her room. The pre-inspection questionnaire confirms that staff receive training in infection control. Staff were observed to use protective gloves and aprons and instructions for correct hand washing to reduce the risk of transferring infection were posted next to staff hand washing facilities. The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. Staff training, recruitment procedures and staffing levels provide good care and protection for residents’. EVIDENCE: Staff on duty at the time of the inspection presented as being caring and professional in their approach to residents’. Discussion with staff, residents and relatives during the inspection identified that there are usually enough staff to meet the needs of residents. At the time of the inspection some staff shortages had occurred due to staff absence putting additional pressure on staff however it was confirmed that this was a temporary situation, and no poor outcomes for residents were identified. The pre-inspection questionnaire identifies that the home currently employ seven first level registered nurses who are responsible for the care of residents assessed as requiring nursing care. Ten out of twenty seven care staff have achieved a National Vocational Qualification (NVQ) at level 2, which provides staff with a basic understanding of the care needs of Older People. This is slightly below the National Minimum The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 19 Standards target of 50 staff being trained to NVQ level 2 however the registered manager confirmed that other staff are currently working towards the qualification which will enable this target to be met. Two staff members spoken to said that training is encouraged and they are currently working towards NVQ3 and another is working towards NVQ4. The pre-inspection questionnaire and discussion with staff identifies that there is a programme of training to enable staff to keep knowledge and skills up to date in order to meet residents’ needs. Discussion with two members of staff confirmed that new staff receive induction training based on the national training organisation specifications and work alongside an experienced member of staff until they are confident and sufficiently competent to meet the needs of residents’. Staff records were not available at the time of this inspection therefore the adequacy of the recruitment process was checked through discussion with two recently recruited staff. Staff confirmed that the procedure includes completion of an application form and an interview. References including a criminal record bureau clearance are obtained. One staff member confirmed that all clearances were obtained prior to starting work. The other was working under the supervision of another staff member until the criminal record bureau clearance had been received, however she confirmed that checks had been made with her previous employer and the protection of vulnerable adults list. The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. The management and organisation of the home is good promoting the health, safety and welfare of the people living in the home. EVIDENCE: Following an application to The Commission for Social Care Inspection the current manager was registered as manager with the Commission for Social Care Inspection. The Manager is a first level nurse and is currently working towards the registered managers award. Although not present at the time of the inspection, brief feedback and discussion during a telephone call following the inspection indicated that the registered manager is receptive to comments made and advice given. The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 21 Residents’ views are sought through residents’ meetings and residents’ spoken to felt that they were able to raise any issues with staff. There is a suggestion box in the hall and copies of questionnaires for people to comment on the service provided. The registered manager advised that questionnaires are sent out to General Practitioners’ approximately every six months to seek feedback on the care provided to residents’. The registered manager advised that one of the directors visit the home every six to eight weeks usually by appointment and occasionally they will ask someone to ring the home to check staff responses. There was no evidence that monthly unannounced visits to the home are being carried out in accordance with the Care Homes Regulations 2001 to review and report on the conduct of the home. The registered manager agreed to discuss this with the directors. The pre-inspection questionnaire identifies the home does not hold any money on behalf of residents’. A staff member advised that residents’ or their relatives are invoiced for items such as hairdressing and purchases from the shop in the home and copies of the receipts forwarded for checking. The pre-inspection questionnaire confirms that regular servicing and maintenance checks on the premises and equipment are carried out. For example servicing of the central heating system, lift and fire equipment. Records confirm that staff receive appropriate training in safe working practices. The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Care plans should be reflective of residents’ current needs and provide staff with clear instruction as to the actions and required to meet residents’ needs. The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Old Vicarage DS0000062531.V294489.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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